This randomized phase III trial studies chlorhexidine gluconate cleansing to see how well it works compared to control cleansing in preventing central line associated bloodstream infection and acquisition of multi-drug resistant organisms in younger patients with cancer or undergoing donor stem cell transplant. Chlorhexidine gluconate may help reduce bloodstream infections and bacterial infections associated with the central line.

Impact of Cleansing With Chlorhexidine Gluconate (CHG) on Reducing Central Line Associated Bloodstream Infection (CLABSI) and Acquisition of Multi-drug Resistant Organisms (MDRO) in Children With Cancer or Those Receiving Allogeneic Hematopoietic Cell Transplantation (HCT)

Number of CLABSI events during the at-risk days [ Time Frame: Up to 90 days ] [ Designated as safety issue: No ]

Estimated and compared between the 2 arms by a Poisson regression model adjusting for the randomization stratification factor on treatment/diagnosis.

Secondary Outcome Measures:

Acquisition of MDRO [ Time Frame: Up to 90 days ] [ Designated as safety issue: No ]

Compared between the two arms using logistic regression. Non-linear mixed effects models will also be used to examine the effect of CHG on the proportion of patients acquiring MDRO with adjustment for the treating institution as random effects.

Susceptibility to CHG as measured by minimum inhibitory concentrations and minimum bactericidal concentrations [ Time Frame: Up to 90 days ] [ Designated as safety issue: No ]

Compared between the two arms using logistic regression. Nonlinear mixed models applied to explore the association between CHG cleansing and reduced susceptibility to CHG over the longitudinal assessments.

Number of bacteremia episodes during the at-risk days [ Time Frame: Up to 90 days ] [ Designated as safety issue: No ]

Poisson regression model used for detecting the reduction in the rate of bacteremia at 2-sided alpha level of 0.05.

Other Outcome Measures:

Patient satisfaction survey [ Time Frame: Up to 90 days ] [ Designated as safety issue: No ]

Descriptive statistics will be used to summarize the responses to the patient satisfaction survey collected at the end of the study. Counts/percentages of patients who consider the study cleansing easy/difficult to use and those of patients satisfied/unsatisfied with the cleansing cloths will be tabulated. The reasons provided for dissatisfaction will also be tabulated. These descriptive statistics will be generated for the entire study population across the 2 arms first and then by each arm.

ONCOLOGY PATIENTS: patients with an oncology diagnosis that are or will be on a chemotherapy regimen that will last for an additional >= 3 months or are on or will be on a chemotherapy regimen for < 3 months and then proceed to transplant (allogeneic or autologous stem cell rescue) during the 3-month study period

Patients with acute myelogenous leukemia (AML) or relapsed acute lymphoblastic leukemia (ALL) that will receive chemotherapy with/without transplant must have, or be scheduled to have, an external tunneled CVC (Broviacs, Hickmans, tunneled PICCs, etc.) and/or non-tunneled PICC that is expected to remain in place for an additional >= 3 months

All other oncology patients that will receive chemotherapy with/without transplant must have, or be scheduled to have, an external tunneled CVC (Broviacs, Hickmans, tunneled PICCs, etc.) that is expected to remain in place for an additional >= 3 months

All patients and/or their parents or legal guardians must sign a written informed consent

All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met

Exclusion Criteria:

Patients with a previous or current line infection are ineligible until 14 days after the completion of antibiotics

Patients with only totally implanted CVCs or ports are ineligible

Patients with a known allergy or hypersensitivity to CHG are ineligible

Patients receiving sorafenib at the time of enrollment and those who are scheduled to receive sorafenib as part of a treatment plan are ineligible

Patients using prophylactic antimicrobial locks in the CVC at the time of enrollment and those who are scheduled to receive antimicrobial locks in the CVC as part of a treatment plan are ineligible

Patients previously enrolled on this trial are ineligible

Females who are pregnant or breastfeeding are ineligible

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Please refer to this study by its ClinicalTrials.gov identifier: NCT01817075